Tadalafil - Overview

Tadalafil is a medication sometimes prescribed to people who want treatment for erectile dysfunction or benign prostatic hyperplasia (BPH). People who might need a tadalafil prescription can use Push Health to connect with a medical provider who can prescribe the medication when appropriate to do so.

What Is Tadalafil Used For?

Tadalafil, marketed under the brand name Cialis, belongs to a class of medications known as phosphodiesterase 5 (PDE5) inhibitors - similar to the same class as sildenafil (Viagra) and vardenafil (Levitra). Tadalafil is the only PDE5 inhibitor with FDA-approved indications for both erectile dysfunction and BPH and is the only one available in a once-daily low-dose formulation that provides efficacy without the need to plan around a pill.

Erectile Dysfunction (ED). Tadalafil is prescribed for erectile dysfunction - the inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It works by relaxing smooth muscle in the corpus cavernosum of the penis, leading to increased blood flow and enabling an erection in response to sexual stimulation. Tadalafil does not cause erections without sexual stimulation and is not an aphrodisiac.

Benign Prostatic Hyperplasia (BPH). Tadalafil 5 mg once daily is FDA-approved for the treatment of BPH. BPH is a non-cancerous enlargement of the prostate gland that causes urinary symptoms including weak urine stream, frequent urination, difficulty starting urination, and nocturia (waking at night to urinate). Tadalafil relaxes smooth muscle in the prostate and bladder neck and helps reduce urinary obstruction. Many men have both ED and BPH simultaneously and tadalafil's dual indication makes it a convenient single medication for both conditions.

Tadalafil - Dosage and Cost

Tadalafil is available as generic tablets in the following strengths:

• 2.5 mg and 5 mg (once-daily dosing and / or BPH)
• 10 mg and 20 mg (as-needed dosing)

The typical starting dose for as-needed ED treatment is 10 mg which may be adjusted to 20 mg or decreased to 5 mg based on the patient's response and tolerability. For as-needed use, only one dose should be taken every 24 hours. For daily dosing, the starting dose is typically 2.5 mg. Tadalafil can be taken with or without food.

Generic tadalafil is highly affordable, typically costing under 50 cents per 5 mg tablet and under $1.50 per 20 mg tablet at many pharmacies. A monthly supply for daily use (30 tablets of 5 mg) typically costs under $15 at most retail pharmacies. Prescription savings cards can help reduce costs further.

Daily Tadalafil vs. As-Needed Tadalafil

Tadalafil is uniquely available in two distinct dosing strategies:

As-needed dosing (10 mg or 20 mg). Tadalafil on an as-needed dosing basis is typically prescribed to be taken approximately 30 minutes to 2 hours before anticipated sexual activity. Tadalafil's effects last significantly longer than other PDE5 inhibitors - up to 36 hours - earning it the nickname "the weekend pill." This dosing is appropriate for men who have sex less frequently or who prefer to dose only when needed.

Daily dosing (2.5 mg or 5 mg). Taken once daily at the same time each day, regardless of sexual activity. Daily low-dose tadalafil provides continuous efficacy without the need to plan around timing of sexual activity. It is also the dose used for BPH. Daily dosing is preferred by many men with more frequent sexual activity (more than twice per week), those who prefer spontaneity, and those who also have BPH.

A licensed medical provider can help determine whether as-needed or daily tadalafil is the better fit based on frequency of sexual activity, presence of BPH, and other individual factors.

Tadalafil vs. Sildenafil (Viagra)

Both tadalafil and sildenafil (Viagra) are PDE5 inhibitors with similar mechanisms and clinical efficacy for ED. The key practical differences are:

	Tadalafil (Cialis)	Sildenafil (Viagra)
Onset of effect	30 min - 2 hours	30-60 min
Duration of effect	Up to 36 hours	4-6 hours
Food interaction	None	High-fat meal reduces absorption
Daily dosing option?	Yes	No
BPH Indication?	Yes	No

Tadalafil's significantly longer duration is its primary differentiator and many men find that the longer window allows for more spontaneity. Sildenafil's faster onset may be preferred by some patients. Both are highly effective, affordable, and have similar side effects. A medical provider can advise on which is most appropriate for a specific patient.

Can I Buy Tadalafil Online?

Tadalafil requires a prescription to be dispensed by a pharmacy in the United States. People who might need a tadalafil prescription can use Push Health to connect with a medical provider who can prescribe the medication to a local or delivery pharmacy when appropriate to do so.

Tadalafil - Side Effects

Common side effects of tadalafil include headache, flushing, indigestion, back pain, and muscle aches. These side effects are generally mild and related to the medication's vasodilatory effects. Tadalafil is not guaranteed to work for everyone.

Nitrate contraindication. Tadalafil and all PDE5 inhibitors should not be used with nitrate medications such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, and amyl nitrite (poppers) as the combination can cause severe hypotension (dangerously low blood pressure).

Vision and hearing changes. Sudden vision loss (including non-arteritic anterior ischemic optic neuropathy, NAION) and sudden hearing loss or tinnitus have been reported rarely with PDE5 inhibitor use. Patients experiencing sudden vision or hearing changes during tadalafil use should stop the medication and seek immediate medical attention.

Blood pressure medications. Tadalafil can cause additive blood pressure lowering when taken alongside antihypertensive medications, alpha-blockers (such as tamsulosin, commonly used for BPH), and heavy alcohol use. Dizziness and lightheadedness when standing are the most common manifestations. Patients on blood pressure medications should discuss tadalafil use with their provider.

Alcohol use. Heavy alcohol use should be avoided while taking the medication. Both substances can lower blood pressure and their combination can cause additive hypotension, leading to dizziness and lightheadedness when standing.

Patients with certain cardiovascular conditions should not use the medication without careful medical evaluation. Patients with a known hypersensitivity to the medication or similar drugs should not use it. Patients who have an erection for longer than 4 hours while using the medication should seek emergency care immediately.

How to Get Tadalafil with Push Health

1. Complete a brief health intake. Answer a few questions about your symptoms, whether you're seeking treatment for ED, BPH, or both, current medications, and any relevant cardiac history.
2. Connect with a licensed medical provider. A provider will review your information and evaluate whether tadalafil is appropriate and which dose and dosing schedule is the best fit. Same-day consultations are available.
3. Receive your prescription. If tadalafil is appropriate, your provider will send a prescription to a pharmacy of your choice - no office visit required.
4. Get your medication. Generic tadalafil is available at most retail pharmacies same day and many delivery pharmacies. The medication typically costs under $15 per month for daily dosing. No health insurance is required.

More Tadalafil Information

• Tadalafil - Medline